Will the Republican Healthcare Bill (the BCRA) Pass the Senate?

How likely is the Senate to pass the BCRA?

There’s currently an 5.42% chance the Republican healthcare bill, known as the BCRA (its version of the AHCA), passes the Senate.

Update, June 23, 2:30 CT: Senator Dean Heller (R-NV) has announced his opposition to the bill. His state has expanded Medicaid — this seemed to play a major role in his decision (as did his 2018 reelection hopes). The four Tea Partiers (Ted Cruz, Mike Lee, Ron Johnson, and Rand Paul) who announced opposition one June 22 have not yet come back on board; most analysts expect Cruz, Lee, and Johnson to ultimately support the bill. Paul may well oppose the healthcare reform because it doesn’t go far enough in cutting Medicaid. His support, for now, remains unlikely. For sake of projecting whether the vote will ultimately pass, I have assumed Cruz, Lee, and Johnson will each vote in favor. McConnell cannot afford to lose one more vote, though there’s a 95% chance he will do so.

Update, June 21, 1p CT: Senators Ted Cruz (R-TX), Mike Lee (R-UT), Rand Paul (R-KY), and Ron Johnson (R-WI) have all announced they cannot yet vote for the bill. Unless they change their minds, the AHCA will not pass. However, Cruz has outlined a path to “yes” — the others likely have similar demands in mind. Negotiations will likely bring them back on board.

Currently, 11 Republican senators have expressed reservations about the healthcare bill. Six of the 11 come from states that expanded Medicaid under the Affordable Care Act (ACA) and would stand to lose federal funding should the BCRA/AHCA be enacted.

The table below shows the likelihood that the currently undecided senators will support the bill. (Please see here for methodology.)

Senator

State

Likelihood of Supporting the AHCA

Susan Collins

Maine

28%

Lisa Murkowski

Alaska

47%

Shelley Moore Capito

West Virginia

63%

Rob Portman

Ohio

62%

How Probabilities Have Changed Over Time

Healthcare Overview

The bill, which barely passed the House, caught flak from Democrats and even Republicans for its secretive drafting process. A select group of Republican senators worked behind closed doors to write the legislation, only revealing the bill to the Republican caucus on June 21, a week before Majority Leader Mitch McConnell (R-KY) hopes to vote on the package.

In May, the Congressional Budget Office found that the healthcare bill version passed by the House would result in 23 million fewer individuals insured than under the ACA. Estimates showed the bill would save around $150 billion, savings attained by cutting Medicaid by more than $800 billion. Few healthcare groups, patient-advocacy organizations, and think-tanks support the AHCA.

Since Republicans will try to pass the healthcare bill via reconciliation (a parliamentary budget gimmick), they only need 50 senators to support the AHCA (with Vice President Mike Pence) casting the tie-breaking vote. They have 52 members in the Senate, so McConnell can afford two defections. Moderates may oppose the bill because of its large cuts to Medicaid; conservatives because it doesn’t fully repeal the ACA.

Voters do not like the bill. A recent Kaiser Family Foundation poll found that only 8% believe the Senate should pass the AHCA. Morning Consult found that just 30% approve of the AHCA, with Republican opposition doubling in the past month. Still, having run numerous campaigns premised on repealing the ACA, Republicans feel pressure to pass some sort of healthcare reform, even in the face of public opposition.

This post will be updated as lawmakers announce their support or opposition to the bill.